Intern App

BETHEL LUTHERAN CHURCH
Summer Intern Employment Application

APPLICANT INFORMATION- PERMANENT ADDRESS
Last Name Street Address City Phone State E-mail Address First M.I. Date
Apartment/Unit # ZIP
APPLICANT INFORMATION- SCHOOL ADDRESS

Street Address City Phone Date Available Are you a citizen of the United States? Have you ever been convicted of a felony? State E-mail Address Social Security No. YES YES NO NO If no, are you authorized to work in the U.S.? If yes, explain YES NO Zip
INTERN PROGRAM SPECIFICS

Please number the following ministry areas (0-5) according to your level of INTEREST, with 5 being the highest. Childrens Ministry ____ Building Management (Facilities & Grounds) ____ Latino Ministry ___ Music Ministry ____ Pastoral Care Ministry ____ Family Ministry/ Congregational Life ____
Briefly state why you are passionate about your top choice(s).
EDUCATION
High School From College From Other From To To To Address Did you graduate? YES NO Degree
Address Did you graduate? YES NO Degree
Address Did you graduate? YES NO Degree
Are there any training courses or seminars which you have completed and feel have helped prepare you for the ministry experience which you are applying for? If so, please list the course title, date completed and how you will use what you learned this summer on internship.
Page 1 of 3 Bethel Lutheran Church Summer Intern Job Application updated 3/22/2012
REFERENCES
Please list three professional references.
Full Name Company Address Full Name Company Address Full Name Company Address Relationship Phone ( ) Relationship Phone ( ) Relationship Phone ( )
PREVIOUS EMPLOYMENT
Company Address Job Title Responsibilities From To Reason for Leaving YES NO Phone Supervisor Starting Salary $ Ending Salary $ ( ) Starting Salary Phone Supervisor $ Ending Salary $ ( )
May we contact your previous supervisor for a reference? Company Address Job Title Responsibilities From To Reason for Leaving
May we contact your previous supervisor for a reference? Company Address Job Title Responsibilities From To Reason for Leaving
YES
NO Phone Supervisor ( )
Starting Salary
Ending Salary
May we contact your previous supervisor for a reference?
YES
NO
STRENGTHS & WEAKNESSES

List your top three strengths and top three weaknesses. Strengths 1. 2. 3. Weaknesses 1. 2. 3.
Please number the following skill areas (0-5) according to your level of EXPERIENCE, with 5 being the highest. Computer Skills ______ Interpersonal Skills Written & Oral ____ Leadership Skills ____ Problem Solving Skills____ Organizational Skills ____ Other Please Explain___________________
Please note any additional skills or interest:
MINISTRY PROFILE
Please number the following ministry areas (0-5) according to your level of EXPERIENCE, with 5 being the highest. Childrens Ministry ____ Building Management (Facilities & Grounds) ____ Family Ministry/ Congregational Life ____ Latino Ministry ____ Music Ministry ____ Pastoral Care Ministry ____
What aspects of ministry excite you? What aspects of ministry does not excite you? Your responses should be included with your completed application. Please include brief responses to the following questions. Your responses should be included with your completed application. 1) Please describe your faith journey. How has your journey prepared you for this position? 2) How does this position fit into your short and long term goals? 3) What do you hope to gain from this intern experience?
BACKGROUND CHECK & SIGNATURE

This form authorizes the church to obtain background information and must be completed by the applicant. Name (first, middle, last) Other names used (maiden, nickname, alias) Drivers License Number & State Current Address In the interest of safety and security, I, the undersigned applicant, authorize Bethel Lutheran Church to procure background information about me, prior to, and at any time during my service to the organization. This report may include my driving history, including any traffic citations; a social security number verification; present and former addresses; criminal and civil history/ records; and the state offender records. I understand that I am entitled to a complete copy of any background information report of which I am the subject upon my request. For a copy of this report, please contact Pr. Scot Sorensen. I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. Signature Date Gender Date of Birth

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BETHEL LUTHERAN CHURCH

Summer Intern Employment Application

APPLICANT INFORMATION- SCHOOL ADDRESS

INTERN PROGRAM SPECIFICS

Address Did you graduate? YES NO Degree

Address Did you graduate? YES NO Degree

May we contact your previous supervisor for a reference?

STRENGTHS & WEAKNESSES

Please note any additional skills or interest:

BACKGROUND CHECK & SIGNATURE

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